Define your relationship with: Mohammad Khazem

Type of relation *

Owner means that you are in a Direct relationship with the missing person, as a family member or a friend. Non-Owner means that you are in an Indirect relationship with the missing person, but you have information about him/her through a direct relationship.

Personal info

Your contact details will remain confidential and are used to create an account in order to limit any misuse of the website. We might contact you in case we need to verify any of the information.

Email *

Your email address.

Full Name *

Your full name.

Phone *

Your phone number.

Owner

Please provide details between you and the missing person.

Relationship

Select the relation between you and missing person. e.g: I am the (example: mother, daughter, etc) of the missing person.

Owner

Please provide details of the direct owner of missing person.

First Name *

First name of direct owner.

Last Name *

Last name of direct owner.

Email of direct owner.

Phone *

Phone of direct owner.

Relationship

Select the relation between direct owner and missing person.

Notes

The information that ACT is collecting will be used to create a profile page for your loved one(s) on the digital memorial Fushat Amal (Space for Hope).

Upon your consent, ACT will upload the information you shared with us on the online database and make it available to the public. However, ACT will not publish any sensitive information as the name of potential perpetrators or witnesses in addition to hate messages or foul language.

You can decline to answer any question except those that are mandatory to create a missing profile (name of the missing and date of disappearance).

If you change your mind regarding any specific data you do not want us to include, please contact us and we will not upload it to the database.

You can also update or add any information, photos, videos and testimonies by going back to the profile page of the missing or by contacting us.

Any other relative (i.e. family member, friend) can share additional information, photos, testimonies, etc. on your missing person profile page by going on the profile and click on update. Act will be in charge of checking the accuracy of any information received before putting it online on the database and public.

ACT may need to contact you back if any information is missing or if we need to cross check any information received by other persons. For this purpose you are asked to share your contact details, which will remain confidential in ACT’s database.

If you note any non-accurate information on your loved one(s) please either update the profile page of your missing on the digital memorial website or contact us so we can verify any discrepancy.

I certify that I have read the consent form that entitles ACT for the disappeared to use the information I provide as detailed in the text above. *

If you are not the relative of the missing person and would like to fill the form on behalf of the relatives of the missing person, please certify that the relatives are aware of the information enclosed in the consent form *

I accept that ACT for the Disappeared shares my contact information with the International Committee of the Red Cross who is working on the issue of the missing in Lebanon.

Leave this field blank

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